Increase in children with postural tachycardia syndrome after the COVID-19 pandemic

For many children and teenagers, standing up quickly can trigger a wave of dizziness, a pounding heart, or a sudden headache. While these feelings are often fleeting, for some, they signal a deeper issue with how the body manages blood flow when shifting from sitting to standing. This condition, known as orthostatic intolerance, occurs when the circulatory system struggles to adjust to the pull of gravity, leaving the brain temporarily short on oxygen. One specific form of this problem, called postural tachycardia syndrome, or POTS, is characterized by a heart rate that spikes too high upon standing without a corresponding drop in blood pressure. It is a condition that can make daily life difficult, often forcing young people to miss school or withdraw from activities they once enjoyed. In recent years, doctors have noticed a troubling rise in the number of children seeking help for these symptoms, a trend that has coincided with the global disruptions caused by the pandemic.

A team of researchers at Kansai Medical University in Japan set out to understand this shift by looking at a long stretch of time. They examined medical records from over 12 years, tracking 632 children between the ages of 12 and 15 who came to their clinic because they suspected they had problems with standing up. To get a clear picture, the doctors used a consistent method: having each child lie down and then tilt them upright at a steep angle for ten minutes while carefully monitoring their heart rate and blood pressure. This allowed the team to categorize the children's conditions and see how the patterns changed before, during, and after the years when schools were closed and children were asked to stay home.

The study revealed a clear and significant change in the types of conditions affecting these young patients. While POTS was already the most common diagnosis among children with orthostatic issues overall, the landscape shifted dramatically after the pandemic began. The number of children diagnosed with POTS increased by 84%, rising from 99 cases in the years leading up to 2020 to 182 cases in the years that followed. In total, POTS became the dominant diagnosis, affecting nearly two out of every three children with orthostatic problems in the later period. The researchers found that this increase was not a sudden spike that happened overnight, but rather a steady climb that accelerated during the years when strict activity restrictions were in place, peaking between 2020 and 2022.

The authors suggest that this surge is likely linked to how the pandemic changed the way children lived. During the lockdowns, many young people spent long periods indoors with limited physical activity. The researchers point to a concept called deconditioning, which describes what happens to the body when it stops moving enough to stay fit. Just as a muscle weakens without exercise, the body's ability to regulate blood flow can deteriorate when a person is inactive for too long. This physical decline, combined with the stress and anxiety that many children faced during those years, may have created a perfect storm that triggered or worsened symptoms of POTS. The study notes that while the increase in cases is clear, it is difficult to say exactly how much of the rise was caused by the virus itself versus the lifestyle changes that came with it, as the researchers did not track infection history or vaccination records.

What remains certain from this extensive review of medical data is that the world of pediatric health has changed. The number of children struggling with the inability to stand comfortably has grown substantially, with postural tachycardia syndrome becoming the primary concern for doctors in this field. The findings highlight a connection between a sedentary lifestyle and the body's circulatory health, suggesting that the long periods of inactivity during the pandemic left a lasting mark on the physical well-being of a generation of young people. As medical professionals continue to monitor these trends, the focus remains on understanding how to help these children regain their strength and return to their daily lives without the burden of constant dizziness and fatigue.